Rates of superbug MRSA infection among children have risen dramatically in the past ten years, according to a study.
MRSA infection is increasing rapidly among children
Researchers from St George's Hospital in London and the Health Protection Agency found infection rates increased 19-fold between 1990 and 2001.
The authors said action must be taken now to ensure rates do not increase further, and called for a national review of risk factors.
The report was published in the Archives of Disease in Childhood.
Not only is MRSA infection a potentially serious illness in its own right, there are fears that it could render other antibiotics, used to treat childhood conditions such as impetigo, useless.
High infant rate
Recent reports have shown an alarming overall increase in MRSA (methicillin resistant Staphylococcus aureus) infection rates.
But this study focused on MRSA rates in children up to 15 years of age.
Only four cases of MRSA were reported in 1991, but by 2001, numbers had increased to 77.
Infants under the age of one accounted for 53% of all cases.
MRSA began to pose a threat in the 1980s, but the new study says it is now a serious problem in England and Wales, and should be a concern for both patients and doctors.
Infection with MRSA can, in a minority of cases, cause a condition called bacteriaemia, which often leads to a long hospital stay and, in vulnerable patients, can be deadly.
The best way to prevent the spread of the bug in hospitals is to ensure good standards of hygiene - in particular health workers should ensure their hands are clean at all times.
Dr Georgia Duckworth, an HPA MRSA expert, said: "Children who succumb to MRSA infections are usually very sick already and therefore vulnerable to infection and it is often difficult to tell where the infection was acquired.
"The levels of MRSA infection in children are still very low relative to older age groups, but we must take steps to ensure that MRSA infection in children does not increase to the same levels as adults."
Dr Hermione Lyall, a consultant in paediatric infectious disease at St Mary's Hospital in London said the majority of infections were likely to have occurred in babies born prematurely.
She told BBC News Online: "MRSA is more common in premature babies who have had long stays in hospital, requiring intravenous nutrition and treatment, and are exposed to antibiotics."
In an accompanying editorial, Dr Jim Gray, of Birmingham Children's Hospital, pointed to research from the US that showed up to 60% of all childhood MRSA cases are acquired outside hospital.
"Many of these cases occurred in children with few or no risk factors for acquisition of MRSA, suggesting that MRSA is circulating among children in those communities," he said.
Dr Gray said he has seen some evidence of this in England.
"I've seen children who are several years old, who haven't been in hospital since birth, who have MRSA," he told BBC News Online.
Dr Lyall said if the infection becomes established in the community then it will become more difficult for clinicians to treat.
"We need to find out more, what the risk factors are and where infections are coming from," she said.
Dr Gray said taking action now could stop, and potentially reverse, the current increase in MRSA.
Health Minister John Hutton said reducing preventable infection rates in
hospitals was a "top priority" for the NHS.
"The Chief Medical Officer is working with doctors and nurses at every level
of the service to try and get on top of this problem," he told BBC Radio 4's
"It is a concern and obviously we want to do all that we can to improve our
performance and bear down on preventable rates of infection," he said.
Shadow Health Secretary Tim Yeo said the new study gave lie to the government's claim of high standards of hygiene in hospitals.
"The unfortunate reality is that there are huge variations in the standards
of cleanliness within English hospitals."
Liberal Democrat health spokesman Paul Burstow said: "The government has been complacent on tackling superbugs.
"Infection control teams are struggling with inadequate resources and are under-valued by hospital management."